Friday, July 24, 2009


Anita, maybe 10, was carried in by her family. She laid on the bed with her knees bent and her hips flexed, not wanting to move anything. She had significant pain on her L hip, so at home had been laying on her R hip and subsequently developed a pressure sore on that side. She had sores on both sides of her mouth and ulcers on her tongue, she hadn't been eating for at least a week. She kept her R arm bent, as she had swelling of her R elbow and cried when I touched it and tried to straighten it. She had increased frequency of urination, but on exam had a very distended bladder. I tried to get her to move her legs, but she said she couldn't due to the pain. She allowed me to move her R leg minimally and evaluate her hip joint, but cried and grimaced as soon as I touched her L thigh. She also had some swelling of her R ankle, and 3rd L finger. When I first looked at her, I wasn't sure exactly what was going on, but (as Bill would/did say) she looked like she was a POW. She was malnourished and very sick. Finding pus in her elbow gave me the answer to what was wrong with her. Pus and subsequent sepsis makes people very sick, if untreated. Everything that was swollen had pus in it that we were able to drain - her elbow, her R foot and ankle, her 3rd finger, her L femur, and her bladder. Yep, you read that right. We put the foley in to drain her bladder, and got out about 700 cc of urine, then the nursing student, Stacey, told me there was blood in it. I went to look and wasn't real concerned by what I was seeing, until I started to see pus, frank pus, coming out of the foley. I found the US machine and looked at her bladder and sure enough, found a lot of pus sitting in the bottom of her bladder, I had never seen this before. I got Bill to check it out, he hadn't seen it before either. We irrigated the foley and got out more pus, hopefully all of it. Thankfully, she is here now and we will do all we can to help her. I pray that after draining all the pus, giving her antibiotics, and fattening her up she will get better, but she has a long road ahead of her, pray she gains strength from the meds and from Him.